Linkages Between Community Mental Health Services, Homelessness, and Inmates and Probationers with Severe Mental Illness: An Evidence-Based Assessment; Closing the Gap Between Medical Autonomy & Effective Treatment for American Inmates with Severe Mental Illness

Weiler, Carolyn, School of Engineering and Applied Science, University of Virginia
Smith, Michael, EN-Eng Sys and Environment, University of Virginia
White, K., EN-Eng Sys and Environment, University of Virginia
Alonzi, Loreto, PV-Data Science Institute, University of Virginia
Baritaud, Catherine, EN-Engineering and Society, University of Virginia

The mass incarceration of Americans with severe mental illness is a long-established crisis tracing back to the 1950s, when the deinstitutionalization movement closed the doors of mental asylums nationwide. Since its beginning many decades ago, the crisis has continued to mount in severity and has now reached a point at which it can no longer be ignored. The STS research paper analyzes this crisis from a macroscopic viewpoint, exploring its beginnings, how these fed into the current American prison climate, and the ways in which society may approach a solution in the future. The technical research report establishes a narrower scope specific to the Central Virginia Criminal Justice System, analyzing local datasets and characterizing the inmate population in an effort to produce findings with which policymakers may make more informed decisions in the future. Together, with the inherently intertwined missions of improving mental health care within prisons and ending the recidivism cycle in America, the two reports seek to improve the overall quality of life of Americans with severe mental illness.
With the closure of psychiatric hospitals in favor of community-based treatment methods, prisons became the de-facto solution for mental health care. Over the past fifteen years, research teams on the technical project have studied data from the Central Virginia region to better understand the nature and extent of the individuals in the criminal justice system who live with severe mental illness. Specifically, this year’s work sought to examine the individuals’ dynamic paths through the various community resources, and to incorporate geocoding to determine whether an individual’s proximity to treatment centers has an impact on their linkage to mental health services. The research team analyzed data across 48 months from July 2015 to June 2019. These data comprise 8,332 individuals booked into Albemarle/Charlottesville Regional Jail (ACRJ), 13,340 individuals who received Region Ten Community Services Board (R10) mental health or substance abuse services, 2,117 individuals in a locally maintained database of homeless individuals, and 4,345 individuals who received services from Offender Aid and Restoration (OAR), which supervises individuals on local probation.
Further, the two central analyses of geolocation and the individuals’ dynamic path yielded several important conclusions. Findings demonstrate a significant improvement in linkage to treatment when the individual is geographically closer to the location at which the treatment is administered, and that 70% of individuals linked to both jail and local mental health treatment were seen first by the jail. These two findings imply first that there is a potential need to link individuals to treatment closer to their homes, and second that more proactive measures should be taken to ensure that these individuals receive treatment before they have a chance to enter the criminal justice system. The final conclusions of the research will be used to support a grant to increase funding to the local therapeutic docket, which continues to keep individuals with severe mental illness out of prison facilities.
The STS research paper explores the central question as to how society may go about most effectively managing inmates with severe mental illness without compromising their medical autonomy. The research concludes that ultimately prison diversion programs, such as therapeutic dockets, prove to be the most effective method, especially when coupled with an enhancement in national public mental health education. The research is drawn from a variety of sources, including several professional medical journals as well as a number of personal journalistic pieces to demonstrate the impacts of the crisis on both a large and small scale.
The research presents a number of unsettling truths about the American criminal justice system, one of which is the inadequacy or complete lack of treatment within prison facilities. Further, even when treatment is available, individuals are rarely referred to continued outside treatment upon release, and they are left on their own. These findings, coupled with the fact that individuals are often sent to jail, rather than the hospital, during mental health crises demonstrate that prison diversion programs should be implemented nationally along with an enhancement of mental health education in order to mitigate the mass incarceration crisis.
With the common goal of enhancing treatment for offenders with severe mental illness, the technical and STS research papers examine the crisis from both a national and a local viewpoint. Without understanding the impacts of large-scale change on a small community, and vice versa, there would be no hope of improvement. Therefore, the technical paper seeks to provide the data that will support the final recommendations made in the STS paper.

BS (Bachelor of Science)
Social Construction of Technology, Mental Illness, Criminal Justice, Institutionalization, Data Analytics

School of Engineering and Applied Science
Bachelor of Science in Systems Engineering
Technical Advisors: Michael C. Smith, K. Preston White, Loreto Pete Alonzi
STS Advisor: Catherine Baritaud
Technical Team Members: Henry Bramham, Claire Deaver, Sean Domnick, Emma Hand, Emily Ledwith, Noah O'Neill

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